Provider Demographics
NPI:1457344384
Name:MONSERRATE, PABLO E (MD)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:E
Last Name:MONSERRATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G1 CALLE SAN MATEO
Mailing Address - Street 2:URB. ALTURAS DE SAN PEDRO
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-5074
Mailing Address - Country:US
Mailing Address - Phone:787-738-7499
Mailing Address - Fax:
Practice Address - Street 1:G1 CALLE SAN MATEO
Practice Address - Street 2:URB. ALTURAS DE SAN PEDRO
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-5074
Practice Address - Country:US
Practice Address - Phone:787-738-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine